• Title/Summary/Keyword: Step-by-Step Measurement

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An Operations Study on a Home Health Nursing Demonstration Program for the Patients Discharged with Chronic Residual Health Care Problems (추후관리가 필요한 만성질환 퇴원환자 가정간호 시범사업 운영 연구)

  • 홍여신;이은옥;이소우;김매자;홍경자;서문자;이영자;박정호;송미순
    • Journal of Korean Academy of Nursing
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    • v.20 no.2
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    • pp.227-248
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    • 1990
  • The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

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Detection Characteristics of PSL and TL Methods in Spices Irradiated with Different Radiation Sources (조사선원에 따른 향신료의 PSL과 TL 검지 특성)

  • Kim, Kyu-Heon;Kwak, Ji-Young;Kim, Jung-Ki;Hwang, Cho-Rong;Lee, Jae-Hwang;Park, Yong-Chjun;Kim, Jae-I;Jo, Tae-Yong;Lee, Hwa-Jung;Lee, Sang-Jae;Han, Sang-Bae
    • Journal of Radiation Industry
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    • v.7 no.1
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    • pp.15-21
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    • 2013
  • The detection characteristics of irradiated spices were investigated depending on radiation sources and doses by photostimulated luminescence (PSL) and Thermoluminescence (TL). 6 kinds of spices (turmeric, onion powder, red pepper, basil, parsley, black pepper) were irradiated at 0 to 10 kGy under ambient conditions by both a $^{60}Co$ gamma irradiator and an electron beam (EB) accelerator, respectively. The PSL analysis showed negative results for non-irradiated spices, while irradiated spices gave intermediate and positive value, which presented the limited potential of PSL technique. In TL measurement, TL glow curves on non-irradiated samples appeared at about $300^{\circ}C$ with low intensity. All irradiated samples were easily distinguishable through radiation-specific strong TL glow curves with maximum peak in range of $150{\sim}200^{\circ}C$. TL ratio ($TL_1/TL_2$) obtained by a re-irradiation step could verify the detection result of $TL_1$ glow curves, showing ratios lower than 0.1 in the non-irradiated sample and higher than 0.1 in irradiated ones. Therefore, in PSL measurement, the identification of irradiated spices showed more clear results in electron beam irradiated samples. TL analysis showed obvious difference between non-irradiated and irradiated samples in gamma ray and electron beam irradiated samples.

Comparison of the Efficacy of 2D Dosimetry Systems in the Pre-treatment Verification of IMRT (세기조절방사선치료의 환자별 정도관리를 위한 2차원적 선량계의 유용성 평가)

  • Hong, Chae-Seon;Lim, Jong-Soo;Ju, Sang-Gyu;Shin, Eun-Hyuk;Han, Young-Yih;Ahn, Yong-Chan
    • Radiation Oncology Journal
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    • v.27 no.2
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    • pp.91-102
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    • 2009
  • Purpose: To compare the accuracy and efficacy of EDR2 film, a 2D ionization chamber array (MatriXX) and an amorphous silicon electronic portal imaging device (EPID) in the pre-treatment QA of IMRT. Materials and Methods: Fluence patterns, shaped as a wedge with 10 steps (segments) by a multi-leaf collimator (MLC), of reference and test IMRT fields were measured using EDR2 film, the MatriXX, and EPID. Test fields were designed to simulate leaf positioning errors. The absolute dose at a point in each step of the reference fields was measured in a water phantom with an ionization chamber and was compared to the dose obtained with the use of EDR2 film, the MatriXX and EPID. For qualitative analysis, all measured fluence patterns of both reference and test fields were compared with calculated dose maps from a radiation treatment planning system (Pinnacle, Philips, USA) using profiles and $\gamma$ evaluation with 3%/3 mm and 2%/2 mm criteria. By measurement of the time to perform QA, we compared the workload of EDR2 film, the MatriXX and EPID. Results: The percent absolute dose difference between the measured and ionization chamber dose was within 1% for the EPID, 2% for the MatriXX and 3% for EDR2 film. The percentage of pixels with $\gamma$%>1 for the 3%/3 mm and 2%/2 mm criteria was within 2% for use of both EDR2 film and the EPID. However, differences for the use of the MatriXX were seen with a maximum difference as great as 5.94% with the 2%/2 mm criteria. For the test fields, EDR2 film and EPID could detect leaf-positioning errors on the order of -3 mm and -2 mm, respectively. However it was difficult to differentiate leaf-positioning errors with the MatriXX due to its poor resolution. The approximate time to perform QA was 110 minutes for the use of EDR2 film, 80 minutes for the use of the MatriXX and approximately 55 minutes for the use of the EPID. Conclusion: This study has evaluated the accuracy and efficacy of EDR2 film, the MatriXX and EPID in the pre-treatment verification of IMRT. EDR2 film and the EPID showed better performance for accuracy, while the use of the MatriXX significantly reduced measurement and analysis times. We propose practical and useful methods to establish an effective QA system in a clinical environment.

Optimal Operation of Gas Engine for Biogas Plant in Sewage Treatment Plant (하수처리장 바이오가스 플랜트의 가스엔진 최적 운영 방안)

  • Kim, Gill Jung;Kim, Lae Hyun
    • Journal of Energy Engineering
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    • v.28 no.2
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    • pp.18-35
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    • 2019
  • The Korea District Heating Corporation operates a gas engine generator with a capacity of $4500m^3 /day$ of biogas generated from the sewage treatment plant of the Nanji Water Recycling Center and 1,500 kW. However, the actual operation experience of the biogas power plant is insufficient, and due to lack of accumulated technology and know-how, frequent breakdown and stoppage of the gas engine causes a lot of economic loss. Therefore, it is necessary to prepare technical fundamental measures for stable operation of the power plant In this study, a series of process problems of the gas engine plant using the biogas generated in the sewage treatment plant of the Nanji Water Recovery Center were identified and the optimization of the actual operation was made by minimizing the problems in each step. In order to purify the gas, which is the main cause of the failure stop, the conditions for establishing the quality standard of the adsorption capacity of the activated carbon were established through the analysis of the components and the adsorption test for the active carbon being used at present. In addition, the system was applied to actual operation by applying standards for replacement cycle of activated carbon to minimize impurities, strengthening measurement period of hydrogen sulfide, localization of activated carbon, and strengthening and improving the operation standards of the plant. As a result, the operating performance of gas engine # 1 was increased by 530% and the operation of the second engine was increased by 250%. In addition, improvement of vent line equipment has reduced work process and increased normal operation time and operation rate. In terms of economic efficiency, it also showed a sales increase of KRW 77,000 / year. By applying the strengthening and improvement measures of operating standards, it is possible to reduce the stoppage of the biogas plant, increase the utilization rate, It is judged to be an operational plan.

A Comparative Study on the Effective Deep Learning for Fingerprint Recognition with Scar and Wrinkle (상처와 주름이 있는 지문 판별에 효율적인 심층 학습 비교연구)

  • Kim, JunSeob;Rim, BeanBonyka;Sung, Nak-Jun;Hong, Min
    • Journal of Internet Computing and Services
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    • v.21 no.4
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    • pp.17-23
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    • 2020
  • Biometric information indicating measurement items related to human characteristics has attracted great attention as security technology with high reliability since there is no fear of theft or loss. Among these biometric information, fingerprints are mainly used in fields such as identity verification and identification. If there is a problem such as a wound, wrinkle, or moisture that is difficult to authenticate to the fingerprint image when identifying the identity, the fingerprint expert can identify the problem with the fingerprint directly through the preprocessing step, and apply the image processing algorithm appropriate to the problem. Solve the problem. In this case, by implementing artificial intelligence software that distinguishes fingerprint images with cuts and wrinkles on the fingerprint, it is easy to check whether there are cuts or wrinkles, and by selecting an appropriate algorithm, the fingerprint image can be easily improved. In this study, we developed a total of 17,080 fingerprint databases by acquiring all finger prints of 1,010 students from the Royal University of Cambodia, 600 Sokoto open data sets, and 98 Korean students. In order to determine if there are any injuries or wrinkles in the built database, criteria were established, and the data were validated by experts. The training and test datasets consisted of Cambodian data and Sokoto data, and the ratio was set to 8: 2. The data of 98 Korean students were set up as a validation data set. Using the constructed data set, five CNN-based architectures such as Classic CNN, AlexNet, VGG-16, Resnet50, and Yolo v3 were implemented. A study was conducted to find the model that performed best on the readings. Among the five architectures, ResNet50 showed the best performance with 81.51%.

Development of Analytic Hierarchy Process or Solving Dependence Relation between Multicriteria (다기준 평가항목간 중복도를 반영한 AHP 기법 개발)

  • 송기한;홍상연;정성봉;전경수
    • Journal of Korean Society of Transportation
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    • v.20 no.7
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    • pp.15-22
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    • 2002
  • Transportation project appraisal should be precise in order to increase the social welfare and efficiency, and it has been evaluated by only a single criterion analysis such as benefit/cost analysis. However, this method cannot assess some qualitative items, and cannot get a proper solution for the clash of interests among various groups. Therefore, the multi-criteria analysis, which can control these problems, is needed, and then Saaty has developed one of these methods, AHP(Analytic Hierarchy Process) method. In AHP, the project is evaluated through weighted score of the criteria and the alternatives, which is surveyed by a questionnaire of specialists. It is based on some strict suppositions such as reciprocal comparison, homogeneity, expectation, independence relationship between multi-criteria, but supposing that each criterion has independence relation with others is too difficult in two reasons. First, in real situation, there cannot be perfect independence relationship between standards. Second, individuals, even though they are specialists of that area, do not feel the degree of independence relation as same as others. This paper develops a modified AHP method for solving this dependence relationship between multi-criteria. First of all. in this method, the degree of dependence relationship between multi-criteria that the specialist feels is surveyed and included to the weighted score of multi-criteria This study supposes three methods to implement this idea. The first model products the degree of dependence relationship in the first step for calculating the weighted score, and the others adjust the result of weighted score from the basic AHP method to the dependence relationship. One of the second methods distributes the cross weighted score to each standard by constant ratio, and the other splits them using Fuzzy measure such as Bel and Pl. Finally, in order to validate these methods, this paper applies them to evaluate the alternatives which can control public resentments against Korean rail path in a city area.

Quantitative Assessment Technology of Small Animal Myocardial Infarction PET Image Using Gaussian Mixture Model (다중가우시안혼합모델을 이용한 소동물 심근경색 PET 영상의 정량적 평가 기술)

  • Woo, Sang-Keun;Lee, Yong-Jin;Lee, Won-Ho;Kim, Min-Hwan;Park, Ji-Ae;Kim, Jin-Su;Kim, Jong-Guk;Kang, Joo-Hyun;Ji, Young-Hoon;Choi, Chang-Woon;Lim, Sang-Moo;Kim, Kyeong-Min
    • Progress in Medical Physics
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    • v.22 no.1
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    • pp.42-51
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    • 2011
  • Nuclear medicine images (SPECT, PET) were widely used tool for assessment of myocardial viability and perfusion. However it had difficult to define accurate myocardial infarct region. The purpose of this study was to investigate methodological approach for automatic measurement of rat myocardial infarct size using polar map with adaptive threshold. Rat myocardial infarction model was induced by ligation of the left circumflex artery. PET images were obtained after intravenous injection of 37 MBq $^{18}F$-FDG. After 60 min uptake, each animal was scanned for 20 min with ECG gating. PET data were reconstructed using ordered subset expectation maximization (OSEM) 2D. To automatically make the myocardial contour and generate polar map, we used QGS software (Cedars-Sinai Medical Center). The reference infarct size was defined by infarction area percentage of the total left myocardium using TTC staining. We used three threshold methods (predefined threshold, Otsu and Multi Gaussian mixture model; MGMM). Predefined threshold method was commonly used in other studies. We applied threshold value form 10% to 90% in step of 10%. Otsu algorithm calculated threshold with the maximum between class variance. MGMM method estimated the distribution of image intensity using multiple Gaussian mixture models (MGMM2, ${\cdots}$ MGMM5) and calculated adaptive threshold. The infarct size in polar map was calculated as the percentage of lower threshold area in polar map from the total polar map area. The measured infarct size using different threshold methods was evaluated by comparison with reference infarct size. The mean difference between with polar map defect size by predefined thresholds (20%, 30%, and 40%) and reference infarct size were $7.04{\pm}3.44%$, $3.87{\pm}2.09%$ and $2.15{\pm}2.07%$, respectively. Otsu verse reference infarct size was $3.56{\pm}4.16%$. MGMM methods verse reference infarct size was $2.29{\pm}1.94%$. The predefined threshold (30%) showed the smallest mean difference with reference infarct size. However, MGMM was more accurate than predefined threshold in under 10% reference infarct size case (MGMM: 0.006%, predefined threshold: 0.59%). In this study, we was to evaluate myocardial infarct size in polar map using multiple Gaussian mixture model. MGMM method was provide adaptive threshold in each subject and will be a useful for automatic measurement of infarct size.

Quality Assurance of Patients for Intensity Modulated Radiation Therapy (세기조절방사선치료(IMRT) 환자의 QA)

  • Yoon Sang Min;Yi Byong Yong;Choi Eun Kyung;Kim Jong Hoon;Ahn Seung Do;Lee Sang-Wook
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.81-90
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    • 2002
  • Purpose : To establish and verify the proper and the practical IMRT (Intensity--modulated radiation therapy) patient QA (Quality Assurance). Materials and Methods : An IMRT QA which consists of 3 steps and 16 items were designed and examined the validity of the program by applying to 9 patients, 12 IMRT cases of various sites. The three step OA program consists of RTP related QA, treatment information flow QA, and a treatment delivery QA procedure. The evaluation of organ constraints, the validity of the point dose, and the dose distribution are major issues in the RTP related QA procedure. The leaf sequence file generation, the evaluation of the MLC control file, the comparison of the dry run film, and the IMRT field simulate image were included in the treatment information flow procedure QA. The patient setup QA, the verification of the IMRT treatment fields to the patients, and the examination of the data in the Record & Verify system make up the treatment delivery QA procedure. Results : The point dose measurement results of 10 cases showed good agreement with the RTP calculation within $3\%$. One case showed more than a $3\%$ difference and the other case showed more than $5\%$, which was out side the tolerance level. We could not find any differences of more than 2 mm between the RTP leaf sequence and the dry run film. Film dosimetry and the dose distribution from the phantom plan showed the same tendency, but quantitative analysis was not possible because of the film dosimetry nature. No error had been found from the MLC control file and one mis-registration case was found before treatment. Conclusion : This study shows the usefulness and the necessity of the IMRT patient QA program. The whole procedure of this program should be peformed, especially by institutions that have just started to accumulate experience. But, the program is too complex and time consuming. Therefore, we propose practical and essential QA items for institutions in which the IMRT is performed as a routine procedure.

Analysis of the Dose Distribution of Moving Organ using a Moving Phantom System (구동팬텀 시스템에 의한 움직이는 장기의 선량분포 분석)

  • Kim, Yon-Lae;Park, Byung-Moon;Bae, Yong-Ki;Kang, Min-Young;Lee, Gui-Won;Bang, Dong-Wan
    • The Journal of Korean Society for Radiation Therapy
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    • v.18 no.2
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    • pp.81-87
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    • 2006
  • Purpose: Few researches have been peformed on the dose distribution of the moving organ for radiotherapy so far. In order to simulate the organ motion caused by respiratory function, multipurpose phantom and moving device was used and dosimetric measurements for dose distribution of the moving organs were conducted in this study. The purpose of our study was to evaluate how dose distributions are changed due to respiratory motion. Materials and Methods: A multipurpose phantom and a moving device were developed for the measurement of the dose distribution of the moving organ due to respiratory function. Acryl chosen design of the phantom was considered the most obvious choice for phantom material. For construction of the phantom, we used acryl and cork with density of $1.14g/cm^3,\;0.32g/cm^3$ respectively. Acryl and cork slab in the phantom were used to simulate the normal organ and lung respectively. The moving phantom system was composed of moving device, moving control system, and acryl and cork phantom. Gafchromic film and EDR2 film were used to measure dose ditrbutions. The moving device system may be driven by two directional step motors and able to perform 2 dimensional movements (x, z axis), but only 1 dimensional movement(z axis) was used for this study. Results: Larger penumbra was shown in the cork phantom than in the acryl phantom. The dose profile and isodose curve of Gafchromic EBT film were not uniform since the film has small optical density responding to the dose. As the organ motion was increased, the blurrings in penumbra, flatness, and symmetry were increased. Most of measurements of dose distrbutions, Gafchromic EBT film has poor flatness and symmetry than EDR2 film, but both penumbra distributions were more or less comparable. Conclusion: The Gafchromic EBT film is more useful as it does not need development and more radiation dose could be exposed than EDR2 film without losing film characteristics. But as response of the optical density of Gafchromic EBT film to dose is low, beam profiles have more fluctuation at Gafchromic EBT. If the multipurpose phantom and moving device are used for treatment Q.A, and its corrections are made, treatment quality should be improved for the moving organs.

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Efficient Application of Westgard Multi-Rules and Quality Control Implementation Improvement (Westgard Multi-Rules의 효율적 적용과 조치사항의 개선)

  • Jung, Heung Soo;Oh, Youn Jung;Bae, Jin Soo;Baek, Jin Young;Hwang, Bo ra;Shin, Yong Hwan
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.1
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    • pp.60-64
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    • 2017
  • Purpose Westgard multi-rules application based on test quality improvement and commercialized international standard has been widely used in quality control. However, it is difficult to applicate the Westgard multi-rules in nuclear medicine in vitro tests due to the larger sample sizes and the simultaneous measurement of quality control material and patient sample. This study investigated the usefulness of Westgard multi-rules application in nuclear medicine in vitro tests. Materials and Methods A total of 282 systematic error multi-rules (22s, 101s) recorded in the samsung medical center computer system from January 2013 to June 2016 along with 117 cases of corrective measure record was analyzed. The Quality control implementation is recorded in Hospital information system were divided into 4 high-level areas including quality control material error, experimental procedural error, Kit lot number management error, and others. To prevent quality control material error, the existing method that each staff used their own method was changed. The staff who in charge of managing the quality control material was designated and daily consumption amount of every test was strictly controlled by one person. To prevent other errors, every test step was standardized so that the entire test procedures are identically implemented. Results The total quality control implementation was 117 cases; As a result, 62 quality control material errors were 62 cases, experimental process errors were 24 cases, Kit lot number control errors were 18 cases, and other errors were 13 cases. The quality control material error was corrected and could be used fresh materials within 2 days after thawing. The cases of systemic error were decreased to causes as quality control material error. The quality control materials were reduced above 10 vials to a monthly average. In addition, these errors of experimental processing and Kit lot number were improved by test standardization. Consequently, the cases of 101s and 22s in systematic error rules decreased at least 2 cases to a monthly average. Conclusion To confirm of systematic error through multi-rules application quickly, it is necessary to base on management of the QC material, target values and standard deviation. Moreover, in the event of a systematic error, it was found important to record measures based on test cause analysis. The experiment results are expected to contribute to internal quality control improvement and prompt and accurate result reporting through error recording and causal analysis based on Westgard multi-rules analysis.

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